Handicaps of Childhood

by H. Addington Bruce

Decidedly, then, it is not from anatomical or physiological inability to speak that a stammerer suffers. It is, rather, from a psychological inability. That is to say, the facts just mentioned indicate strongly that stammering is primarily a mental malady—that it is due to the presence, in the mind of the stammerer, of some idea or ideas that inhibit the normal functioning of the organs of speech. This conclusion is confirmed by the additional circumstance that nearly every stammerer who has been questioned on the subject admits that he is perpetually tormented by a haunting dread of not being able to express himself clearly to others, and so of exposing himself to their ridicule, contempt, or pity. Many, indeed, affirm their conviction that if they could only overcome this dread they would be free from their affliction. "I believe," is a characteristic utterance of stammerers, "that if I were to wake up some morning with total forgetfulness that I had ever stammered, I should never stammer again."

Still more significant is the fact that, of the many methods which have been invented for the treatment of stammering—and which include such curious devices as beating time with every word, and wearing artificial supports under the tongue—all have had to their credit a certain—however small—proportion of genuine cures. This would suggest, not that they have been intrinsically valuable, but that, in the cases cured, they so impressed the mind of the stammerer with their therapeutic virtue as to banish his long-entertained belief that he could not talk like other people. For that matter, recent experiments go to bear out the view that almost any method, no matter how fantastic, will cure some stammerers, if only they have a lively faith in its efficacy.

For example, there was once brought to the Boston City Hospital a woman of thirty-five, who, though formerly speaking without any difficulty, had begun to stammer in a frightful manner, following a violent quarrel with her husband. She could utter scarcely a sound, except weirdly inarticulate noises, and these only by a great effort. The physician to whom her case was entrusted soon became satisfied that she was suffering mainly from a profound belief that she would never be able to talk again; and he therefore endeavoured to reason her out of this, but to no purpose. Finally, he abandoned the attempt, and, after leaving her pretty much to her own devices for several days, impressively said to her one morning, in a tone of great authority:

"Well, Mrs. Blank, I have been looking carefully into your case, and I find there is one way certain to cure you. It may be a little painful, but I know you will not mind that, as long as it is going to make you entirely well."

So saying, and with an air of the utmost confidence, he began to apply to her an electric current, just strong enough to make her wince. Only a few treatments of this sort were found necessary to enable the hospital authorities to discharge her as cured—and she stayed cured.

Of late, consequently, with growing recognition of the dominant psychic factor in stammering, there has been an increasing tendency—though as yet it is far from universal—to employ psychological methods in treating stammerers. The effort is made to instil confidence in the sufferer—to convince him that he need only exercise his will power to bring about his own cure. In a good many cases, and frequently with gratifying results, resort is had to hypnotism, the "suggestion" being reiterated to the patient, while in the hypnotic state, that in the future he will experience none of his overwhelming sensations of dread and anxiety and will speak as fluently as persons who have never stammered. Or he may be treated by psychic re-education, which consists essentially in the development of volitional control by suggestions tactfully imparted in the ordinary waking state. All of which unquestionably marks a tremendous advance over the theories and practices based on the alleged anatomical or physiological defects of stammerers.

There is this to be added, though, that, sanely beneficial as is the psychological treatment of stammering, it often happens that the confidence-inspiring suggestions given to stammerers do not "take." The stammerer, albeit he may perhaps show improvement for a time, remains without clear articulatory power. When this occurs, the natural tendency among those treating him—in view of the demonstrated truth that stammering is the effect of a peculiar state of mind—is to throw the blame on the patient instead of on the method. Yet, actually, it is the method that is at fault—or, to be exact, it is the failure to apply the method, which itself is thoroughly sound—in such a way as to remove from the stammerer's mind not only the fear that haunts him and helps to perpetuate his stammering, but also the ideas in which his stammering originated.

Here we come to the central fact in the whole problem of stammering—a fact which, when it is widely enough known and appreciated, is certain to exert a far-reaching influence on the prevention of stammering, as well as its cure. Until very recently, few have been aware of this fact except a small group of foreign investigators, physicians with a psychological training, whose special business it has been to determine scientifically the possibilities, the limitations, and the exact procedures to be followed in supplementing, by wholly mental treatment, the ordinary medical and surgical treatment of disease. Impressed by the predominance of the mental factor in stammering, these investigators were particularly impressed by some of the peculiarities mentioned above—as, the ability of almost every stammerer to speak well when alone or when in a state of abstraction. Such peculiarities, they knew from long experience, bore a strong resemblance to oddities in the behaviour of victims of hysteria, psychasthenia, or other psychoneurosis, in all of which disorders there is a tendency for symptoms to disappear when the sufferer's attention is momentarily withdrawn from them. Accordingly, it seemed to the investigators quite possible that, in the last analysis, stammering was not so much a disease in itself as a psychoneurotic symptom.

They were well aware, for reasons already set forth in these pages, that psychoneurotic disorders have their origin in emotional disturbances of one sort or another, which, occurring to a person of nervous temperament or rendered neurally unstable by a faulty upbringing, react adversely on the entire organism. Exactly what happens is that the emotional disturbance—whether it be a fright, a grief, a worry, or what not—while perhaps completely forgotten by the victim, so far as conscious recollection is concerned, remains subconsciously alive in his memory, is ever seeking to emerge again into conscious remembrance, and, failing to do this, takes its revenge, so to speak, by the production of disease symptoms ranging from mere eccentricities of thought and behaviour to symptoms mimicking those of true organic disease.